The objective is to design, build, and clinically assess an assistive device, PediAccess", which will improve augmentative alternative communication for children with compromised speech and motor function due to cerebral palsy (CP). Speech affects education, communication with family and clinicians, and societal participation. This project will focus on children with CP who cannot speak and have compromised upper extremity motor control that impedes effective use of a standard computer for communication. Some AAC devices currently exist, but all have significant limitations. Some examples include: a simple board that requires the user to gaze at answers; a reflective forehead worn marker that uses head movement and dwell time to move a cursor and select options; a screen that continually cycles highlighted options and waits for a push button triggered by the hand or head to select the option when highlighted; and multiple choice touch screens. While these devices have shown some efficacy to improve communication, they can be slow to navigate, may not be cosmetically acceptable, struggle to maintain calibration, and do not take full advantage of potential degrees of freedom (DOF) remaining for control. Additionally, once communication is lost, a computer typically becomes the interface between cognitive speech intention and fabricated speech output. The hands provide an intuitive method for the computer control interface layer. While a user may not have dexterous motor control required to use a touch screen, they may have enough gross motor function to detect desired arm endpoint (hand) direction. In other words, there may be repeatable patterns of motion in the hand, forearm, upper arm, and shoulder that can be used to detect desired hand direction. PediAccess will utilize remaining voluntary control to detect desired hand direction to navigate through a communication matrix. Furthermore, the user will not need to learn an unconventional control method; navigation through a visual communication matrix will be synergistically mapped to their desired endpoint movements by exploiting repeatable upper extremity motion patterns. The proposed PediAccess will provide a compact, wireless, wearable system to improve the speed and accuracy at which children affected by motor and speech impairments can communicate. The device will utilize comfortable, wearable, sensing technology to detect user arm endpoint intention. The system will employ motion sensors including accelerometers and gyroscopes and a Bluetooth radio transceiver and the wireless design will increase safety and allow comfortable wear for long periods of time. Motion will be wirelessly transmitted to a base station tablet computer. Software will collect and process data and provide a visual communication matrix with provided user selectable responses. Quantitative data and coordination patterns processed from the motion sensors will be used as inputs to train and test an algorithm to detect endpoint intention. Algorithms will translate endpoint intention to communication matrix commands. [unreadable] [unreadable]